naloxone and Affective-Disorders--Psychotic

Topics: Affective Disorders, Psychotic; Animals; beta-Endorphin; Bipolar Disorder; Clinical Trials as Topic; Double-Blind Method; Endorphins; Growth Hormone; Humans; Hydrocortisone; Methylphenidate; Models, Psychological; Naloxone; Prolactin; Schizophrenia

Topics: Adult; Affective Disorders, Psychotic; Bipolar Disorder; Depressive Disorder; Endorphins; Humans; Hydrocortisone; Male; Methadone; Middle Aged; Naloxone; Narcotics; Prolactin; Schizophrenia

Topics: Affective Disorders, Psychotic; Animals; beta-Endorphin; Bipolar Disorder; Clinical Trials as Topic; Double-Blind Method; Endorphins; Growth Hormone; Humans; Hydrocortisone; Methylphenidate; Models, Psychological; Naloxone; Prolactin; Schizophrenia

A double-blind study of the behavioral effects of short-term naloxone hydrochloride administration was performed in 32 schizophrenic and 26 manic patients in a World Health Organization collaborative project. There was a significant naloxone-associated reduction in overall physician-rated symptoms in schizophrenic patients concurrently treated with neuroleptic medication (N = 19) but not in medication-free schizophrenics (N = 13). Physician rating of auditory hallucinations showed significant naloxone-associated improvement for the total schizophrenic population, while self-ratings of auditory hallucinations showed improvement only in neuroleptic-treated schizophrenics. While further studies are needed to delineate these effects as to clinical significance, they may bear etiological implications for the psychobiology of schizophrenia, including the possibility of synergistic effects of dopamine and endorphin blockade. Naloxone produced no significant behavioral effects in manic patients. These findings are discussed with relationship to the hypotheses of endorphin involvement in schizophrenia and mania.

Topics: Adult; Affective Disorders, Psychotic; Aged; Antipsychotic Agents; Bipolar Disorder; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Naloxone; Psychiatric Status Rating Scales; Schizophrenia; Schizophrenic Psychology; World Health Organization

The subjects were 13 psychiatric inpatients with tardive dyskinesia. Each subject participated in two sessions. Either naloxone (10 mg) or placebo was administered intravenously during each session. In a subset of subjects (n = 7), blood samples for beta-endorphin were drawn before and at 30 and 60 minutes after the injection. The Abnormal Involuntary Movement Scale was administered before and at 10, 20, 40, 60, 120, and 360 minutes after the injection. Double-blind procedures were maintained throughout the experiment. Neither naloxone nor placebo had any appreciable effect on the involuntary movements. Naloxone elicited a significant increase in the plasma beta-endorphin.

Topics: Adult; Affective Disorders, Psychotic; Aged; beta-Endorphin; Dyskinesia, Drug-Induced; Endorphins; Female; Humans; Male; Middle Aged; Naloxone; Psychotic Disorders; Receptors, Dopamine; Schizophrenia

Eleven schizophrenic and three manic patients were randomly administered 0.3 mg/Kg b.wt. of naloxone or placebo in a drug-free state using a double blind procedure. BPRS and CGI were employed for making periodic assessment of mental status; the MRS was additionally used for manic patients. The authors discuss their findings, which are essentially negative.

Topics: Adolescent; Adult; Affective Disorders, Psychotic; Bipolar Disorder; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Naloxone; Schizophrenia

Beta-Endorphin (0.3 or 0.6 nanomoles) was infused into the A10-ventral tegmental area (VTA) of male Wistar rats previously treated for 6 days with either morphine sulfate or lactose via subcutaneously implanted silastic pellets. Beta-Endorphin microinfusions occurred at 24 and 96 hours after pellets were removed. Profound changes in locomotor response to beta-endorphin were found, with morphine-pretreated rats showing a spontaneous switch from hyporesponsiveness to hyperresponsiveness over 72 hours, compared to lactose-pretreated controls. These findings may reflect on current biochemical theories regarding the "switch" process in bipolar affective disease. The data can be viewed within a heuristic model of receptor changes which may underlie the transition from depression to mania.

Topics: Affective Disorders, Psychotic; Animals; beta-Endorphin; Bipolar Disorder; Dextroamphetamine; Disease Models, Animal; Endorphins; Humans; Limbic System; Male; Morphine; Motor Activity; Naloxone; Neural Pathways; Rats; Rats, Inbred Strains; Receptors, Dopamine; Substance Withdrawal Syndrome; Tegmentum Mesencephali

Topics: Affective Disorders, Psychotic; Double-Blind Method; Endorphins; Humans; Hydrocortisone; Methadone; Motor Activity; Naloxone; Narcotic Antagonists; Neurotransmitter Agents; Prolactin; Random Allocation; Receptors, Opioid; Schizophrenia

Since 1975, different morphinomimetic peptides have been isolated from hypophyseal-hypothalamic extracts: the pentapeptides methionine-enkephalin and leucine-enkephalin, and the longer peptides alpha-, beta- and gamma-endorphin. The primary structure of most of these peptides is also present in that of beta-lipotropin. The morphinomimetic properties of endorphins can be blocked with opiate-antagonists. In rats, moreover, the endorphins influence behavior which cannot be blocked with opiate antagonists. On the basis of the hypothesis that hyperactivity of endorphin systems may be involved in the pathogenesis of schizophrenia and manic syndromes, the effect of opiate antagonists on psychotic and manic symptoms has been examined in a number of clinical studies in the past few years. A transient therapeutic effect has been demonstrated in about 30% of the patients so treated. Our own double-blind controlled study of 5 schizophrenic and 5 manic patients in the context of a World Health Organization project failed to reveal any therapeutic effect after subcutaneous injection of 20 mg naloxone. The possible reasons of the negative results are discussed.

Topics: Affective Disorders, Psychotic; Bipolar Disorder; Double-Blind Method; Endorphins; Hallucinations; Humans; Naloxone; Schizophrenia

The authors conducted a double-blind placebo-controlled study in which patients with a wide range of manic symptoms were administered 20 mg of naloxone subcutaneously. Naloxone failed to improve manic severity, activation-arousal, or elation-grandiosity for intervals up to 3 hours. Global nurse ratings of mania did not improve over an 8-hour period. The authors suggest that the question of endorphin involvement in mania has not been resolved and recommend clinical studies with longer acting oral narcotic antagonists such as naltrexone.

Topics: Affective Disorders, Psychotic; Bipolar Disorder; Double-Blind Method; Humans; Naloxone; Psychotic Disorders